One of the primary differences between novice and expert physicians is the number of illness scripts experts have developed over the years. These patterns are similar to algorithms, but more individualized to the expert's experience and personal style. The more experienced the expert, the more shortcuts will be included in the individual's patterns because of automaticity.

Newly graduated doctors have spent most of their time in medical school giving the correct answer to questions, they are very good at "right answers" but this skill can present problems in the clinical setting because this desire to be right frequently leads to premature closure of the differential. You can assist learners in a clinical setting to develop their own differential patterns by asking them to graph common illnesses as they progress through their training and by sharing your differential thinking with residents and interns. Illness scripts have the added advantage of forcing the student to think in terms of a broader differential without the power struggle of arguing about a whether a particular diagnosis is correct.

These graphs can be kept in a binder and added to as the learner increases their knowledge. The final graph will be useful for studying for final exams. Both text-based and visual representations are acceptable depending on the student's personal learning preference. See a list of online tools and the NHS Map of Medicine for examples. For people who like a more concrete approach, check out Google Squared.


Caution: Remember this is not your illness script; it is the student's. It will not contain all the knowledge in your brain, nor will it look like what you draw on the board. This is also a developmental tool which will improve over time and experience.

Example of a text based script	Example of a visual script from Visual Mnemonics
To view other examples, go to MedMaps, a great resources for examples of medical mindmapping.	Here is an example of a simple visual image that might be used by a student to remember basic information about diabetes. As the student increases their knowledge, they would add more information and the image will become more complex. This image is also an example of automaticity because the same image represents key phrases that an expert would use to recall complex knowledge.
Another example of a text based script from Allergy Notes	Cardiovascular disease examples Acute Coronary Syndromes pdf Acute Myocardial Infarction – Complications pdf Acute Pulmonary Oedema pdf Acute Right Ventricular Failure pdf Air Embolism pdf Aortic Dissection pdf Australian Resuscitation Council Guidelines – 2006 changes pdf Blood Supply of the Heart pdf Cardiac Physiology pdf Cardiogenic Pulmonary Oedema pdf Conduction Disturbances pdf Deep Vein Thrombosis pdf Endocarditis pdf Fat Embolism pdf Heart Transplant pdf Indications for Adult Cardiac Surgery pdf Levosimendin pdf Mechanisms of Arrhythmia pdf Myocarditits pdf Pericarditis pdf Peripheral Arterial Disease Emergencies pdf Pulmonary Embolism pdf Pulmonary Hypertension pdf Shock pdf Sudden Cardiac Death pdf Supraventicular Arrhythmias pdf Treatment of Severe Heart Failure pdf Troponin in Critical Illness pdf Valvular Disease Emergencies pdf Wide Complex Arrhythmias pdf Wolff-Parkinson-White Syndrome pdf More examples at http://lifeinthefastlane.com/exams/jficm-fellowship/icu-mind-maps

For More Information:
Examples of Scripts from a medical resident

http://journals.lww.com/academicmedicine/Fulltext/2008/07000/A_Conceptual_Framework_for_the_Use_of_Illness.9.aspx
http://www.ncbi.nlm.nih.gov/pubmed/12028392
http://www.ingentaconnect.com/content/bsc/meded/2007/00000041/00000012/art00009;jsessionid=8sr1nf5kr4brc.alexandra?format=print
http://www.fammed.ouhsc.edu/robhamm/OKJDM2000/Hamm/sld001.htm
http://casemed.case.edu/curricularaffairs/scholars/2002-03Archives/scholars0203/PLtoILLgroups.pdf
http://content.nejm.org/cgi/content/full/355/21/2217
http://www.saem.org/download/kuhn.pdf http://www.cogs.susx.ac.uk/users/bend/doh/reporthtmlnode5.html
http://www.informaworld.com/smpp/content~content=a783763088~db=all

http://en.wikipedia.org/wiki/User:Madhero88/MindMaps

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Online Mapping tools
Exploratree this free tool has a variety of online thinking graphs such as identifying supporting evidence and exploring ideas from different perspectives.
MedMaps is a free tool for creating and sharing illness scripts based on a signs and symptoms, characteristics, differential, complications, management formula.



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